Discussion response

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”
References:

Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.
Words Limits

Response posts: Minimum 100 words excluding references.

Discussion 1
When dealing with patients who have different values and cultures, there are many things to consider. Communication is a top priority (Burkhardt & Nathaniel 2014). In order to understand another person, you must be willing to ask questions and be open to learning. You must not place your own values on another. You also need to find ways to incorporate that culture and those beliefs into your nursing care for the patient. Some simple examples are diet requests. The patient can be given a kosher diet, vegetarian or other changes that fit what they need. When you hold a differing value from your patient, you need to put yourself to the side. You need to focus on the patient. I had an elderly woman who was in great shape for her age. However, she was diagnosed with terminal cancer and was going to die soon. She had many loving family members. She might have survived a while longer with interventions, but she chose to go to hospice. I was saddened to think of her giving up. But, “giving up”, I have no right to think that or make the decision. She knows herself, her values and her choices. I’ve had my share of cultural incongruence, where I didn’t understand a culture at all (Ong-Flaherty, C. 2016). I had a patient who was diagnosed with cancer. The patient was unaware of the diagnosis because their family insisted on staff not telling the patient. It was quite the moral dilemma for me. I would want to know, and I was appalled that the patient wasn’t being told. But in their culture, the patient was cared for and not given the stress of that knowledge. That is what they believed to be best. I have an example of patient empowerment and decision making. The patient had a bowel obstruction. I know the best treatment to be bowel rest and an NG tube. I explained the treatment to the patient. The patient always has the right to refuse treatment. This particular patient wanted to eat and drink. The NG was already placed. The patient also wanted Dilaudid, which is contraindicated. I could not bring the patient food or drink, and I had no order to give the patient Dilaudid. I tried listening to the patient. I tried educating the patient. When all of those options failed, I tried getting the doctor to speak to the patient. After all of our efforts, the patient pulled out the NG and walked out the door. There are some limits to patient empowerment. When patient safety is involved, patients lose the rights to make some decisions. In particular, patients with dementia come to mind. Many times I have seen patients dressed and trying to go home at 3 in the morning. They may not know where they are. They have no way to get home and they still desperately need medical treatment. I can’t in all good conscience let them walk out the door.
References:
Burkhardt, M.A. & Nataniel, A.K. (2014). Ethics and Issues in Contemporary Nursing (4th ed.). Stamford, CT: Cengage Learning. pg.479. Ong-Flaherty, C. (2016). Cultural Incongruence in Nursing Education. The American Journal of Nursing, vol. 116 (11), 11.
Discussion 2
The purpose of this discussion is to discuss patient empowerment. Often a nurse and a patient do have different beliefs and values. Being a professional health care worker, we have been taught different ways to deal with these situations and how to handle the ethical dilemmas that may arise. I will give an example of an ethical dilemma and how I responded to what I thought was an unwise decision. I will also give my opinion on patient empowerment.
The factors to consider when a nurse and patient hold different values are things such as the patient’s religion and cultural beliefs. The patient’s own vision of the outcome and where they are in the process of their illness or treatment are also things to consider.
One example I have had working in the operating room where a patient had refused a blood transfusion was an ethical dilemma for me. The patient was Jehovah’s Witness, had their clergy with them the morning of surgery to help fill out paperwork correctly, and signed a blood refusal consent. Before the surgery I have a positive outlook to not have to give blood but with the high risk of blood loss I am always prepared. I had no reservations witnessing that consent in the preoperative department, thinking it was unlikely that blood was needed anyway. An adult is making an informed decision to refuse blood even after risks are discussed (Burkhardt & Nathaniel, 2014). High blood loss, long surgery, and patient’s co morbidities would have been recommendations for a blood transfusion. The surgeon had to talk to family after the surgery and let them know how closely the patient was to be monitored, including a possible extra day of stay due to the outcomes. I did feel that it was unwise to not get blood if needed but my duty as a nurse is to keep my own beliefs out of the situation.
An empowerment program called a care track, with includes occupational therapy, a geriatrician, and an RN is one way to build patient satisfaction and goal building. This is a program built to include the patient and create greater autonomy for the patient (Lofgren, et. al., 2015). The care track takes into consideration the patient’s ADL’s prior to the surgery, the plan for the length of stay in the hospital including rehabilitation, and where the patient is expected to go after rehab. The nurses are taught to be more observant to patient needs and be a coach for the patient. (Lofgren, et.al., 2015). There was a case study that has shown the length of stay for those involved with these interventions was four days shorter than those who did not have these interventions (Lofgren, et. al., 2015)
I do not think there should be limits on patient empowerment only due to the fact that we want our patients involved with their own health care. The goal is to make the patient more autonomous and give them greater responsibility. If the patient is working towards their own goals set by themselves, they are more likely to succeed, as shown in the case study.
In conclusion, we are to help patients and family find the right care based on their beliefs. Even if that means a longer hospital stay, more lab work, and different unconventional interventions for that patient. We are not sales people; we are simply informative healthcare workers wanting the best outcome for our patient. We give patients the resources needed to make the best decision.
References
Burkhardt, M. A., Nathaniel, A.K. Ethics and issues in contemporary nursing, 4th ed., (2014).
Cengage Learning: Stamford, CT.
Lofgren, PT, PhD, S., Hedstrom, MD, PhD, M., Ekstrom, MD, PhD, W., Lindberg, PhD, L.,
Flodin, MD, L., & Ryd, MD, PhD, L. (2015, September 1). Power to the patient: care
tracks and empowerment a recipe for improving rehabilitation for hip fracture patients.
Scandinavian Journal of Caring Sciences, 25, 462-469. doi:10.1111/scs.12157
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I’m studying for my Management class and need an explanation.

I need this discussion response below answer its a total of two question your have to respond to . Please put reference you used . So the questions is in bold letters but you are responding to what they answer below.

2.) (p. 211). Why do you suppose the five categories of classroom training are so popular in HRD? Identify two types of training programs a manager might not want to conduct in using a classroom format.

Human Resource Development (HRD) is the framework for helping employees develop their personal and organizational skills, knowledge, and abilities. Human Resource Development can be formal such as in classroom training, a college course, or an organizational planned change effort. Classroom training is an instructional method that takes place away from the normal work setting. In this sense, a classroom can be any training space that is away from the work site; such as a lecture hall, a company cafeteria, or a meeting room. It is a common instructional method (Werner, 2017). The five categories of classroom training are lecture, debate/discussion, audiovisual media, experimental methods, and computer-based trainings are an integral part of conducting training. These categories of classroom training are popular because each of them brings something different to learning. The significance of these five categories tend to create a composed environment to minimize the interruptions from external factors such as noise and crowds, which helps in creating an environment favorable to training. These categories can assist a larger number of audience than classic on-the-job training can.
Two categories can assist a larger number of an audience than classic on-job training can.

Therefore, two programs which managers might not want to run in the classroom training are audiovisual and simulation techniques. There are following disadvantages of audiovisual techniques. Some videos may contain excess music and dialogs, which may cause trainees to be annoyed. Overloaded dialogs in videos may also mislay the essence of the topic in the presentation itself. Simulation techniques can only be conducted in an artificial environment, which represents real life surroundings. It can lead to several disadvantages due to it being an expensive technique. It may also cause for trainers to update themselves with new tools, machinery, and essential information to keep pace with the real environment.

1.) (p. 254). Even though most HRD professionals agree that HRD evaluation is valuable, in your opinion what are the most important reasons why it isn’t practiced more frequently by organizations? How can these objections to evaluation be overcome?

Even though HRD evaluation is valuable, it is not practiced more frequently by numerous organizations. The purpose of an employee evaluation is to measure job performance. The most important reason is that HR goals are difficult to quantify and measure. Many evaluations provide quantitative measurements essential for a production-oriented work environment. For example, the support that HR provides to the strategic goals of a company is difficult to quantify and measure.

“Organizations must continually assess their

employees’ strengths and weaknesses. By doing

so, employers are better able to match employee

qualification to job assignments. Employee

evaluations provide an assessment of the

strengths and weaknesses for individual

employees as well as the collective talents of

employees by department or team” (Mayhew,

2019).

The goal of aligning an organization to the strategic goals of the company is difficult to assess: reducing HR activities to measurable goals is in most cases. Employee training and development needs are other reasons employee evaluations are important. Assessing employee strengths and weaknesses is the first step in determining the type of training employees need. Training usually supports employees acquiring new skills and development while helping build upon employee aptitude and current performance. Performance measurement through employee evaluations is a component of many organizations’ compensation structures. Employee evaluations give supervisors and managers an opportunity to recognize employees’ hard work, dedication and commitment. Top management should realize the importance of the training activities of the employees and its impact on the success of the organization. Since many training programs tend to transform into failures, it is very important to take feedback and collect data related to the training programs so that the necessary changes can be incorporated into the following training programs in the future.

References

Mayhew, R. (2019). The Importance of an Employee Evaluation. Retrieved from https://smallbusiness.chron.com/importance-employe…

Werner, J. M. (2017). Human Resource Development: Talent Development. (7th ed.). Boston, MA: Cengage Learning.